Epidemiology of laboratory-confirmed respiratory syncytial virus infection in young children in England, 2010–2014: the importance of birth month

Abstract

SummaryThe epidemiology of laboratory-confirmed RSV infections in young children has not recently been described in England, and is an essential step in identifying optimal target groups for future licensed RSV vaccines. We used two laboratory surveillance systems to examine the total number and number of positive RSV tests in children less than five years old in England from 2010-2014. We derived odds ratios with 95% confidence intervals comparing children by birth month, using multivariable logistic regression models adjusted for age, season and sex. 47% of RSV tests (29,851/63,827) and 57% (7,405/13,034) of positive results in children under five years old were in infants younger than six months. Moreover, 38% (4,982/13,034) of positive results were in infants younger than three months.Infants born in September, October and November had the highest odds of a positive RSV test during their first year of life compared to infants born in January (OR=2.1 (95% CI 1.7, 2.7), OR=2.4 (95% CI 2.1, 2.8) and OR=2.4 (95% CI 2.1, 2.7), respectively). Our results highlight the importance of young age and birth month near the beginning of RSV season to the risk of laboratory confirmed RSV infection. Future control measures should consider protection for these groups.3

Burden of paediatric respiratory syncytial virus disease and potential effect of different immunisation strategies: a modelling and cost-effectiveness analysis for England

“…Our estimates for RSV-attributable admissions to hospital are in line with other UK estimates, 13 , 20 , 21 and many reported in western Europe, 22 , 23 but lower than estimates reported for Spain (a full comparison is in the appendix p 8 ). Our findings about the marked seasonality of RSV disease agree with those from a study in England 1 showing that infants born just before or during the RSV season had a much higher risk of laboratory-confirmed RSV in their first year than those born just after the RSV season. 1 …”

“…Our findings about the marked seasonality of RSV disease agree with those from a study in England 1 showing that infants born just before or during the RSV season had a much higher risk of laboratory-confirmed RSV in their first year than those born just after the RSV season. 1 …”

“…Children born in winter had more RSV-attributable GP consultations and admissions to hospital ( figure 1 ), and a higher proportion of their primary care outcomes occurred when they were younger than 6 months (dark red shading in figure 1 ), similar to that previously reported for RSV-attributable laboratory reports. 1 The incidence of RSV-attributable GP consultations in the first year of life fluctuated between 13·9 per 100 children born in March up to 27·4 per 100 children born in November (and similarly from 1·55 per 100 births to 6·47 per 100 births for admissions to hospital).…”

“…Respiratory syncytial virus (RSV) is a highly seasonal respiratory virus (the season runs from from late autumn to early spring). 1 Exposure to RSV does not lead to long-lasting protection and hence people can have many infections over their lifetime. 2 Infection mainly leads to mild disease, but in very young children (aged <6 months), elderly people, and immunocompromised patients it can result in serious disease or death.…”

Meteorological factors and respiratory syncytial virus seasonality in subtropical Australia

“…Acute respiratory infections caused by respiratory syncytial virus (RSV) have a significant impact on global health and in 2015 resulted in an estimated 3.2 million hospital admissions and 59600 in-hospital deaths in children aged <5 years [1]. Factors placing infants at high-risk of severe RSV respiratory infections include preterm birth, underlying chronic cardiopulmonary disorders, young age and being born shortly before an RSV outbreak [2][3][4]. In Australia, population age-adjusted incidence rates for RSV-related hospitalsations are estimated as 8.7-17.4 per 1000 for infants in the first year of life, and 2.2-4.5 per 1000 for children aged <5 years [5,6].…”